Benign Paroxysmal Positional Vertigo (BPPV) is a common inner ear condition that leads to brief episodes of dizziness triggered by head movements. The Modified Epley maneuver is a well-established treatment for BPPV, but questions remain regarding the effectiveness of post-maneuver positional restriction in preventing recurrence. In 2014, a study by Hasan Huseyin Balikci and Isa Ozbay aimed to shed light on this matter.

Seventy-eight patients suffering from unilateral BPPV of the posterior semicircular canal were enrolled in the study, all of whom were treated at the Otorhinolaryngology Department of Susehri State Hospital. After identifying the affected canal using the Dix-Hallpike test, the patients were led through the modified Epley repositioning maneuver, with a maximum of two maneuvers per session. The participants were randomly divided into two groups: one group was advised to follow positional restrictions for ten days after the procedure, while the other group received no such advice. Recurrences within 1-90 days were considered early, while those occurring after 90 days were labeled as late recurrences.

In the group following positional restrictions (n=39), the repositioning maneuver was successful in 82.05% of patients after one attempt and in 12.8% after two attempts. Repositioning failed in 5.1% of patients. In the non-restriction group (n=39), the success rate was similar, with 79.4% achieving repositioning success after a single maneuver, 15.3% after two, and 5.1% experiencing failure. The overall success rate for both groups was 94.8%.

Early recurrence was noted in 8.1% of patients in the restriction group and 5.4% in the non-restriction group, with no significant difference observed (p>0.05). Late recurrence occurred in 13.5% of patients in both the restriction and non-restriction groups, with no statistically significant variation (p>0.05).

The study’s findings indicate that the application of postural restrictions following a canalith repositioning procedure does not lead to an improvement in procedural success or a reduction in early and late recurrence rates. However, it is essential to acknowledge that the study’s sample size may have been too limited to detect potential differences between the two treatment groups. Further research with larger cohorts may provide additional insights into this matter.

Reference: Balikci, H. H., & Ozbay, I. (2014). Effects of postural restriction after modified Epley maneuver on recurrence of benign paroxysmal positional vertigo. Auris Nasus Larynx, 41(5), 428-431.